Strength of Fixation with Transosseous Sutures in Rotator Cuff Repair*

Part I: Footprint contact characteristics for a transosseous-equivalent rotator cuff repair technique compared with a double-row repair technique

“…Although, grossly, the double-row repair would appear to cover the entire footprint, based on this study, the tendon-footprint interface experiences pressurized contact over only 39.6% of the defined footprint, which was significantly less than that achieved by the newly described transosseousequivalent rotator cuff repair with 4 suture bridges (77.6% footprint) (P ϭ .005). * References 2,6,7,9,10,15,17,22,32,35,39,40 . A study by Park et al 29 has shown that a transosseous repair can improve contact area and pressure between the tendon and tuberosity in a bovine model, when compared with single-row suture anchor techniques, thus helping to optimize the potential for healing.…”

“…The medial and lateral fixation points were placed at points where drill holes would be placed for a traditional open transosseous technique. Two 4.5-mm holes were drilled 1 cm distal to the lateral edge of the footprint, 7 each in line with the medial suture anchors distanced 12.5 mm apart in the anteriorposterior direction. A No.…”

Open, Mini-open, and All-Arthroscopic Rotator Cuff Repair Surgery: Indications and Implications for Rehabilitation

“…An approximately 1.5-cm bridge of hard cortical bone is preferred between the medial and lateral drill holes, with the lateral hole exiting cortical bone distal to the greater tuberosity to optimize tendonbone healing and fixation strength. 9 A braided nylon suture is passed through the bony tunnels, then through the tendon, with at least a 1-cm cuff of tissue. A simple suture technique is used for repair.…”

Biomechanical Test for Repair Technique of Full-thickness Rotator Cuff Tear

“…Initial fixation strength is an essential consideration in optimizing rotator cuff repair and therefore, numerous biomechanical studies have focused on elucidating the strongest devices, knots, and repair configurations for rotator cuff repair. [6][7][8] To restore the footprint area, numerous arthroscopic techniques have been studied. Recently, the transosseous-equivalent (TOE) technique has become popular with sutures from the medial row of anchors coming across the rotator cuff and being secured laterally in the footprint.…”